IGF-I and symptoms of acromegaly according to time since somatostatin receptor ligand injection.

IF 5.2 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

European Journal of Endocrinology Pub Date : 2025-09-26 DOI:10.1093/ejendo/lvaf200

Ilan Remba-Shapiro, Júnia R O L Schweizer, Alberto Moscona-Nissan, Karen J P Liebert, Pamela S Jones, Katharina Schilbach, Jessica Naredo Rojas, Michelle Adams, Vicky O Cheng, Nicholas A Tritos, Martin Bidlingmaier, Lisa B Nachtigall

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引用次数: 0

Abstract

Background: Somatostatin receptor ligands (SRLs) are the mainstay pharmacotherapy for acromegaly. Patients report symptoms towards the end of the injection cycle. However, the correlation between IGF-I and patient-reported outcomes (PROMs) has not been evaluated in this context.

Objective: To determine IGF-I, PROMs, and SRL concentration variability in patients with acromegaly receiving long-acting SRLs.

Methods: Quality of life surveys, early and late phase (weeks 1 and 4 after SRL injection) biochemical markers, and SRL concentrations were obtained in 20 patients receiving monthly SRLs during two injection cycles. All IGF-I levels were measured using both mass spectrometry (LC-MS) and an immunoassay (IDS-iSYS).

Results: IGF-I concentrations were higher during late vs. early phase of cycle 2 using LC-MS (179.5±85.6 ng/mL vs. 154.8±80.2 ng/mL, p=0.045) and IDS-iSYS (201.2±86.3 ng/mL vs. 165.5±75.8 ng/mL, p=0.023) assays. In cycle 1, PASQ scores worsened in week 4 (18.10±11.96) compared to week 2 (15.53±9.94; p=0.011) and week 3 (15.00±12.49; p=0.021). SRL concentrations were lower during late phase (3563±1444 pg/mL vs. 2588±1085 pg/mL; p=0.008). Change in (Δ)SRL negatively correlated with ΔIGF-I IDS-iSYS (r=-0.385, p=0.047). ΔACROQoL physical significantly correlated with ΔIGF-I. Δsoluble alpha-klotho (sαKL) corelated with ΔPASQ score (r=0.337, p=0.034) and swelling (r=0.335, p=0.035).

Conclusions: IGF-I concentrations increased according to time since SRL injection. PROMs fluctuated, correlating with IGF-I and sαKL changes. Measuring IGF-I at the end of the injection cycle is advisable. Decreases in SRL concentration suggest phase-based differences in IGF-I concentrations. These findings inform personalized approaches to acromegaly, with titration of therapy based on individual IGF-I and/or PROMs fluctuation.

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生长抑素受体配体注射后不同时间IGF-I与肢端肥大症症状的关系

背景：生长抑素受体配体（SRLs）是肢端肥大症的主要药物治疗方法。患者在注射周期结束时报告症状。然而，在这种情况下，igf - 1与患者报告结果（PROMs）之间的相关性尚未得到评估。目的：测定接受长效SRL治疗的肢端肥大症患者的IGF-I、PROMs和SRL浓度变异性。方法：对20例每月接受SRL治疗的患者进行两个注射周期的生活质量调查、早期和晚期（注射后1周和4周）生化指标和SRL浓度测定。使用质谱法（LC-MS）和免疫分析法（IDS-iSYS）测量所有IGF-I水平。结果：用LC-MS（179.5±85.6 ng/mL比154.8±80.2 ng/mL, p=0.045）和IDS-iSYS（201.2±86.3 ng/mL比165.5±75.8 ng/mL, p=0.023）测定，IGF-I浓度在周期2晚期高于早期。在第1周期，PASQ评分在第4周（18.10±11.96）比第2周（15.53±9.94,p=0.011）和第3周（15.00±12.49,p=0.021）恶化。晚期SRL浓度较低（3563±1444 pg/mL vs. 2588±1085 pg/mL; p=0.008）。（Δ）SRL的变化与ΔIGF-I IDS-iSYS呈负相关（r=-0.385, p=0.047）。ΔACROQoL物理与ΔIGF-I显著相关。Δsoluble α -klotho （s - α kl）与ΔPASQ评分（r=0.337, p=0.034）、肿胀（r=0.335, p=0.035）相关。结论：注射SRL后，IGF-I浓度随时间升高而升高。PROMs有波动，与IGF-I和s - α kl的变化相关。建议在注射周期结束时测量igf - 1。SRL浓度的降低表明IGF-I浓度存在阶段性差异。这些发现为肢端肥大症的个性化治疗提供了依据个体IGF-I和/或PROMs波动进行治疗的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Endocrinology 医学-内分泌学与代谢

CiteScore

9.80

自引率

3.40%

发文量

354

审稿时长

1 months

期刊介绍： European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica. The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology. Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials. Equal consideration is given to all manuscripts in English from any country.